Open AccessReversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult
Author(s) -
Yajuan Lv,
Yan Zhang,
Ning Liang,
Fengjun Liu,
Ruixue Liu
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000017787
Subject(s) - medicine , apatinib , leukoencephalopathy , cancer , gastroenterology , disease
Rationale: Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by rapidly progressive hypertension, headache, and disturbance of consciousness. Moreover, RPLS is rarely reported after apatinib treatment. Patient concerns: We present a case of RPLS induced by apatinib in this report. The patient had dizziness and bilateral lower limb weakness after apatinib use for 12 days. Diagnosis and interventions: Cranial T2-weighted magnetic resonance imaging (MRI) revealed symmetrical increased signal intensity in bilateral areas of the basal ganglia, radiation crown, frontal lobe, parietal lobe, and occipital lobe, which was suggestive of RPLS. The patient discontinued apatinib use and was administered dexamethasone, mannitol, and antihypertensive drugs. Outcomes: The patient's blood pressure returned to normal and neurological symptoms improved after 3 days of discontinuation of apatinib use. Moreover, brain MRI showed complete resolution of previous changes after 44 days of discontinuation of apatinib use. Lessons: Increased blood pressure may damage the normal blood-brain barrier, resulting in the extravasation of the fluid into the brain parenchyma. Hypertension is a significant cause of RPLS. It is important to strictly monitor blood pressure during apatinib treatment.